As the opioid crisis drives expansion of integrated opioid use disorder (OUD) treatment programs in generalist settings, these programs will contend with significant rates of co-occurring alcohol use. The authors present a brief literature review and commentary regarding nondisordered and disordered alcohol use in OUD treatment settings and biochemical detection techniques. Biochemical testing for alcohol in integrated OUD treatment settings is both important for detecting alcohol use disorder and feasible. Breathalyzer testing may assist with management of acutely intoxicated patients. Biochemical testing for alcohol is an important part of integrated OUD treatment. More research is needed on the impact of alcohol use on OUD treatment outcomes and the role of breathalyzer testing in management of intoxicated patients in the outpatient setting.
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http://dx.doi.org/10.1097/ADM.0000000000000784 | DOI Listing |
JAMA Netw Open
January 2025
San Francisco Department of Public Health, San Francisco, California.
Importance: The rise of high-potency opioids such as fentanyl makes buprenorphine initiation challenging due to the risks of precipitated withdrawal, prompting the exploration of strategies, such as low-dose initiation (LDI) of buprenorphine. However, no comparative studies on LDI outcomes exist.
Objective: To evaluate outpatient outcomes associated with 2 LDI protocols of buprenorphine among individuals with opioid use disorder (OUD) using fentanyl.
Drug Alcohol Depend Rep
March 2025
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States.
Aim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD.
Methods: Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018-9/30/20.
Addiction
January 2025
Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA.
Background And Aims: Opioid smoking is becoming more common in the United States. The aim of this analysis was to estimate relative mortality risk among those who primarily smoke opioids compared with those who inject.
Design: Retrospective propensity score-matched cohort analysis.
Contemp Clin Trials
January 2025
New York State Psychiatric Institute, 1051 Riverside Dr., New York, NY 10032, USA; Columbia University Irving Medical Center, 630 West 168(th) St., New York, NY 10032, USA. Electronic address:
Introduction And Background: The three medications approved to address OUD are effective in decreasing opioid use and morbidity and mortality; however, their utility is limited by high rates of dropout from treatment. The CTN-0100 trial will develop an evidence base for strategies to improve retention on buprenorphine and extended-release naltrexone.
Research Design And Methods: The National Drug Abuse Treatment Clinical Trials Network (CTN) study CTN-0100, "Optimizing Retention, Duration and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy" (RDD), is a multicenter, randomized, non-blinded trial enrolling more than a thousand patients from 18 community-based substance use disorder treatment programs.
J Gen Intern Med
January 2025
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Background: Hepatitis C virus (HCV) infections and injection drug use have concurrently increased in the last decade. Evidence supports simultaneously treating chronic HCV and opioid use disorder (OUD) with medication. Kentucky is a hard-hit state for both conditions that has undertaken policy and practice efforts to increase access to both types of medications.
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